Web resources on diabetic eye disease mostly poor quality

Diabetes-related eye disease is a leading cause of blindness, but finding accurate, readable information about it online isn’t easy, a U.S. study finds.

Researchers rated 11 top search-engine-ranked websites about diabetic retinopathy. They found that some were accurate and complete but too technical, while others were easy to read but lacked in quality. None scored highly on all of the standards examined.

“While this paper specifically pertains to diabetic retinopathy, a very common eye disorder, the takeaway message about the general quality of online medical resources likely pertains to all medical conditions,” said Dr. Christopher Starr, of the NewYork-Presbyterian and Weill Cornell Medicine in New York City, who wasn’t involved in the study.

Patients increasingly rely on the internet for health-related queries, and past research shows that online information can influence patients’ decisions about their care, the study team notes in JAMA Ophthalmology.

To assess the information available online, researchers designed a 26-question survey based on topics a doctor would discuss with a patient diagnosed with diabetic retinopathy. Three ophthalmology experts used the survey to assess whether a website answered all the questions a patient would have about the condition and possible treatments.

Wikipedia was the top-scoring site, with information that was the most complete and relevant to patients, while WebMD ranked the lowest on these measures. Websites set up by American Optometric Association and American Academy of Ophthalmology also got poor scores.

“Wikipedia has always done better than a lot of other (encyclopedia) websites out there. It does surprise me that some of the websites that are written by ophthalmology organizations did not score better,” noted Dr. Rahul Khurana of Northern California Retina Vitreous Associates in Mountain View, who wrote an editorial accompanying the study.

The researchers used a standard readability scale to measure how easily readers would understand the material. Overall, readability scores averaged at the 11th-grade level, far higher than the U.S. Department of Health and Human Services recommendation for a 6th-grade reading level.

WebMD got the best score for readability while Wikipedia scored the worst, although the analysis found no correlation between quality and readability.

“It’s hard to make this information at a sixth or eighth grade reading level. But to make the information useful for a patient they have to be able to understand it,” Khurana said in a phone interview.

The researchers also assessed whether a site indicated how current the information is, clearly identified the authors and contributors, and provided references for the sources of information. None of the websites met all of these benchmarks.

Researchers found no correlation between a website’s quality and its search engine ranking.

Involving people who are not physicians in developing health websites could help ensure that the information is at an appropriate reading level and answers the common questions raised by patients, Dr. Jayanth Sridhar of the Bascom Palmer Eye Institute at the University of Miami, the study’s senior author, said in a phone interview.

Despite the limitations of existing websites, both Starr and Khurana said they see some value in using the internet to learn about medical conditions, as long as patients also consult with a physician instead of relying on self-diagnosis.

“In reading these websites, the information gathered should be used, not as dogma, but as the foundation for a more highly informed one-on-one discussion with your doctor at your next visit,” Starr said.

“And if it’s been a while, reading these websites will hopefully remind diabetic patients of the importance of regular screening exams for diabetic retinopathy,” Starr added.